Retrospective investigation of the frequency and risk factors of pneumonitis DUE to immune checkpoint inhibitors

Introduction-Aim: Immüne checkpoint inhibitors revolutionize the treatment of various malignancies and they can be a rare but life-threatening pneumonitis side effect, although not as much as other cytotoxic chemotherapy. Pneumonitis is a general term used as inflammation of the lungs. The possible risk factors and chronology of this side effect, which can cause significant morbidity and mortality, aren't known clearly. In this study, we aimed to contribute to reducing mortality and morbidity by determining the frequency of pneumonitis toxicity and possible risk factors in patients who were given İmmüne checkpoint inhibitor therapy for various malignancies. Materials and Methods: We compared the thorax CT scans taken before and after the treatment of the patients who were followed up in the Medical Oncology and Chest Diseases clinics of Dicle University Faculty of Medicine and received immune checkpoint inhibitor therapy between January 2016 and October 2021 for various malignancies. Patient record were evaluated retrospectively, with the diagnosis and grading recommendation specified in the relevant guidelines. Results: 117 patients were included in our study. Of these patients, 77 (65.8%) were male and 40 (34.2%) were female. The mean age was 57.2 (22-88) years. It was determined that 15 (12.8%) patients developed pneumonitis of different degrees, which was thought to be associated with an immüne checkpoint inhibitor. It was observed that all grade pneumonitis developed in an average of 5 months (2-9 months). Potential risk factors affecting the development of immüne checkpoint inhibitorassociated pneumonitis by multivariance logistic regression analysis of our data; It was observed that there was a correlation between the presence of lung disease, previous RT that included the thorax, and combined treatment with nivolumab and ipilimumab. Conclusion: Newly developed respiratory symptoms should be carefully considered in populations treated with immüne checkpoint inhibitors. If necessary, it should be discussed in a multidisciplinary committee including pulmonologists. Keywords: Malignancy, Immünotherapy, Immüne Checkpoint Inhibitors, Pneumonitis